Anthem Blue Cross leads California exchange enrollment two months in

Anthem Blue Cross employees greet people at a Los Angeles enrollment fair in preparation for the Affordable Care Act rollout.

Anthem Blue Cross employees greet people at a Los Angeles enrollment fair in preparation for the Affordable Care Act rollout.

(Dan Krauss / Los Angeles Times)

Chad Terhune

Amid rising enrollment for healthcare insurance in California, industry giant Anthem Blue Cross has seized the early lead with a 30% share of the state's exchange market.

Two major rivals, Blue Shield of California and Kaiser Permanente, aren't far behind in newly released state figures.

Overall, the Covered California exchange said 156,143 people have selected a private health plan through Dec. 7. An additional 179,000 Californians have been deemed eligible for Medi-Cal, the state's Medicaid program.

The pace of enrollment has escalated sharply ahead of the federal Affordable Care Act's Dec. 23 deadline to get coverage starting Jan. 1.

Consider this: Nearly 31,000 Californians enrolled for health insurance during the month of October. About that same number of people signed up in just two days earlier this week, the state said.

The other seven insurers in Covered California combined for 4,197 enrollees, or 4%. In other words, the state's four largest health insurers hold 96% of the exchange market after two months of a six-month enrollment window that lasts until March 31.

Some healthcare experts have questioned whether this trend portends a lack of competition in the exchange if small upstarts can't gain a foothold.

Peter Lee, executive director of Covered California, said the competitive angle is better judged on a regional basis because many of the smaller health plans aren't selling statewide.

The exchange said it plans to release more details on company enrollment by region next week.

"While the majority of enrollment across the state is in four plans, it's different when you look region by region," Lee said.

The latest data also offer some clues about what type of coverage people are choosing. Under the Affordable Care Act, most people can pick from among four tiers -- Bronze, Silver, Gold and Platinum.

Bronze plans are the cheapest and offer the least amount of coverage toward a person's medical bills. Silver is the next plan up, then Gold and on to Platinum, which represents the most comprehensive and expensive coverage.

Sixty-one percent of Californians in the exchange picked Silver in October and November. Bronze was next with 20%, followed by 10% for Platinum and 8% for Gold.

As expected, lower- and moderate-income people receiving federal premium subsidies opted more for Bronze and Silver plans. Those two plans accounted for 85% of their choices.

More affluent consumers went for richer benefits. Nearly 40% of them bought Gold or Platinum policies.

Through November, 86% of people getting coverage through the exchange qualified for premium subsidies.